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General NPI Number Information
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NPI Number | 1851181093
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Entity Type | Organization
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Legal Business Name | AMBIENTMINDS BEHAVIORAL & WELLNESS CENTER PLLC
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Dates
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Enumeration Date | 05/10/2025
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 3030 WARRENVILLE RD STE 450-06
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City | LISLE
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State | IL
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Zip | 60532-1000
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Country | US
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Telephone | 567-262-4368
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Fax |
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Provider Business Mailing Address
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Address Line | 3030 WARRENVILLE RD STE 450-06
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City | LISLE
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State | IL
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Zip | 60532-1000
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Country | US
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Telephone | 567-262-4368
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LATEEF KELANI
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Credential | PMHNP-BC
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Telephone | 567-262-4368
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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